February 1996

Prospective Study of Recurrent Radial Head Subluxation

Author Affiliations

From the Division of Emergency Medicine, Children's Hospital of Buffalo (NY), and School of Medicine and Biomedical Sciences, State University of New York at Buffalo (Dr Teach); and the Division of Emergency Medicine, Children's Hospital and Harvard Medical School, Boston, Mass (Dr Schutzman).

Arch Pediatr Adolesc Med. 1996;150(2):164-166. doi:10.1001/archpedi.1996.02170270046006

Objectives:  To calculate a recurrence rate for radial head subluxation (RHS) and to identify risk factors for recurrence.

Design:  Prospective cohort study.

Setting:  Pediatric emergency department of an urban, tertiary care children's hospital.

Patients:  Consecutive sample of 107 children younger than 6 years with definite (n=94) or probable (n=13) RHS enrolled during a 6-month period and followed up for at least 12 months.

Main Outcome Measure:  Recurrent episodes of RHS.

Results:  Follow-up information was available on 86.9% (93/107) patients, with a mean±SD of 16.4±1.9 months (range, 12 to 20 months). Of these 93 patients, 22 (23.7%) had recurrent RHS. Among the patients who had their first episode of RHS during the study period (n=76), those with recurrences were significantly younger than those without (21.7±9.9 months vs 29.2±13.5 months, respectively, P=.04, t test). Those 24 months or younger had a relative risk of 2.60 for one or more recurrences during the study period (95% confidence interval, 1.04 to 6.30) compared with those older than 24 months. No differences were observed in duration of follow-up, sex, elbow involved in the initial episode, or family history of RHS between those with and without recurrences.

Conclusions:  Recurrent RHS occurs in nearly one fourth of patients, and those 24 months or younger are at greatest risk. Sex, family history, and the elbow involved in the initial episode are not risk factors for recurrence.(Arch Pediatr Adolesc Med. 1996;150:164-166)